[27F] Experiencing irregular menstrual cycle and pain during sex

Patient Description

A 27-year-old female presents with a several-month history of irregular menstrual cycles, characterized by periods that are excessively long or absent for extended durations. She reports sharp pain during sex rated 8/10, particularly with deep penetration, which has been ongoing for 2 months and is associated with significant bleeding post-intercourse. The patient also describes a swollen cervix and has been experiencing large amounts of unusual, sometimes bloody, vaginal discharge for several months. Additionally, she suffers from severe cramping and pelvic pain during menstruation, rating the discomfort as 9/10, which has been a long-standing issue for several years. She also experiences bloating, which she attributes to hormonal changes, and atypical bowel movements with occasional constipation leading to painful defecation. The patient has one recurring sexual partner, with the last unprotected encounter in January, and prior unprotected contact in June/July without subsequent testing for sexually transmitted infections. There is no reported weight change, known drug allergies, or current medications, and she has no significant past medical history.

Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be possible:

Endometriosis: This is a condition where tissue similar to the lining of the uterus is found outside of the uterus. It can cause painful periods, pain during sex, and irregular periods. It can also cause digestive issues like bloating and constipation.
- Treatment typically involves medication to manage pain and hormonal therapy to slow the growth of the endometrial tissue. In some cases, surgery may be necessary.
Cervical Polyps: These are growths on the cervical canal, the passage that connects the uterus to the vagina. They can cause irregular menstrual bleeding, bleeding after sex, and an unusual discharge.
- Treatment typically involves removal of the polyp.
Sexually Transmitted Infections (STIs): Certain STIs, like gonorrhea or chlamydia, can cause unusual discharge and bleeding after sex.
- Treatment typically involves antibiotics.
Cervicitis: This is an inflammation of the cervix that can be caused by a number of different factors, including STIs, allergies, or physical trauma. It can cause pain during sex, unusual discharge, and bleeding after sex.
- Treatment depends on the cause but may include antibiotics or antiviral medication.

Please remember that this is not an exhaustive list and these conditions have other symptoms not mentioned in your description.

What you can do

Given the severity and duration of your symptoms, it's important to seek medical attention. Here are some steps you can take:

Schedule an appointment with a healthcare provider: They can perform a physical examination and order tests to help determine the cause of your symptoms.
Keep track of your symptoms: Note when they occur, their severity, and anything that makes them better or worse. This information can help your healthcare provider in diagnosing your condition.
Practice safe sex: Use condoms to reduce the risk of STIs.

What you should look out for

Seek immediate medical attention if you experience:

Severe abdominal pain
Heavy bleeding
Fever
Fainting or dizziness

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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1 yr ago

Top picked over-the-counter products for Painful Periods (Dysmenorrhea)